• Anatomy and Cell Biology
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• v.57 no.2
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• pp.204-212
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• 2024

In the present study, anatomical assessment of zygomaticofacial foramina (ZFFs) and zygomatic canals communicating with ZFFs were performed using cadaver micro-computed tomography images. It was suggested that all ZFFs were located above the jugale (Ju)-zygomaxillare (Zm) line, which is the reference line connecting the Ju and Zm, and most were located in the zygomatic body area (ZBA). The anteroposterior position of the ZFF in the ZBA was within a middle to posterior region and was most often located slightly posteriorly in males and closer to the middle of the region in females. The mean distance from the Ju-Zm line to the ZFF in the ZBA was 12.36 mm (standard deviation [SD] 1.52 mm) in males and 11.48 mm (SD 1.61 mm) in females. In zygomatic canals communicating with ZFFs, most zygomatic canals were type I canals, communicating from the zygomaticoorbital foramen and harboring the zygomaticofacial nerve, and the others were type II canals, communicating from the zygomaticotemporal foramen and located near the posterior margin of the frontal process. These results provide useful anatomical information for preventing nerve injury during surgical procedures for zygomatic implant treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.4
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• pp.260-264
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• 2013

Calcium hydroxide root canal filing paste (vitapex) is widely used as canal filling paste for infected canal. However, chemical burn is possible because of the high alkali base of calcium hydroxide. A 57-year old woman was admitted to our clinic for consistent dull pain and paresthesia in the left upper lip, zygoma and buccal cheek area, which developed during an endodontic treatment of the left lateral incisor. Radiographic finding showed radiopaque material, which exits from the left incisor root apex, and was within the left canine and first premolar buccal soft tissue. The overfilled Vitapex extended to the soft tissue was surgically curetted. The result of the surgical curettage was favorable. Though slight hypoesthesia on the upper lip was still remained, paresthesia on zygomatic and buccal cheek area was completely recovered. As far as we know, this is the first case report of infraorbital nerve damage from overfilled Vitapex material.

• Journal of Korean Neurosurgical Society
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• v.54 no.6
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• pp.477-483
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• 2013

Objective : Although surgical techniques for clipping paraclinoid aneurysms have evolved significantly in recent times, direct microsurgical clipping of large and giant paraclinoid aneurysms remains a formidable surgical challenge. We review here our surgical experiences in direct surgical clipping of large and giant paraclinoid aneurysms, especially in dealing with anterior clinoidectomy, distal dural ring resection, optic canal unroofing, clipping techniques, and surgical complications. Methods : Between September 2001 and February 2012, we directly obliterated ten large and giant paraclinoid aneurysms. In all cases, tailored orbito-zygomatic craniotomies with extradural and/or intradural clinoidectomy were performed. The efficacy of surgical clipping was evaluated with postoperative digital subtraction angiography and computed tomographic angiography. Results : Of the ten cases reported, five each were of ruptured and unruptured aneurysms. Five aneurysms occurred in the carotid cave, two in the superior hypophyseal artery, two in the intracavernous, and one in the posterior wall. The mean diameter of the aneurysms sac was 18.8 mm in the greatest dimension. All large and giant paraclinoid aneurysms were obliterated with direct neck clipping without bypass. With the exception of the one intracavenous aneurysm, all large and giant paraclinoid aneurysms were occluded completely. Conclusion : The key features of successful surgical clipping of large and giant paraclinoid aneurysms include enhancing exposure of proximal neck of aneurysms, establishing proximal control, and completely obliterating aneurysms with minimal manipulation of the optic nerve. Our results suggest that internal carotid artery reconstruction using multiple fenestrated clips without bypass may potentially achieve complete occlusion of large paraclinoid aneurysms.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.6
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• pp.565-569
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• 2001

A new surgical approach to the area of the infratemporal fossa and parapharyngeal space is described. This approach results in a wide-field exposure of the infratemporal fossa, pterygomaxillary space and parapharyngeal space. We used two osteotomies on the patient's mandible and temporary resection of zygomatic arch for superior margin of tumor. Lower lip splitting was not needed because the incision was started in the frontal scalp, curved in front of and below the external auditary canal, and extended anteriorly to the greater horn of hyoid bone on the neck along a skin crease. We had good results without sacrifice of the facial nerve, mandibular function and sensory supply of the face and oral cavity.

• The Korean Journal of Pain
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• v.5 no.2
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• pp.263-268
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• 1992

Involvement of the facial nerve(herpes zoster oticus, Ramsay Hunt Syndrome) is a rather common clinical syndrome. It begins with unilateral ear pain, followed shortly by a peripheral facial palsy. Paresis or paralysis may affect the muscles of facial expression, which also close the eyelids. The levator palpebrae which is innervated by the 5th cranial nerve is spared, so the eye may remain open. The rash is usually confined to the tympanic membrane and the external auditory canal. It may spread to involve the outer surface of the lobe of the ear, anterior pillar or the fauces and mastoid. There also may be a loss of taste in the anterior two thirds of tongue. At time, the auditory nerve involvement produces tinnitus, deafness and vertigo. The 5th, 8th and 10th nerves and even the upper cervical spinal nerve can be involved presumedly on the base of spread of the infective process along anastomotic connections between the facial nerve. The facial paralysis is identical to that of Bells palsy. Frequently the recovery of facial nerve function is incomplete, leaving the patient with some residual facial weak ness. We experienced 2 cases of Ramsay Hunt Syndrome. The first patients, 55 year old male, visited our pain clinic on the day when his left facial nerve start to paralyze. We injected 6 ml of 0.25% bupivacaine into his left stellate ganglion 15 times. TENS was also applicated simultaneously. His facial paralysis was recovered completely 3 weeks after treatment without any complications. Another one, 53 year old male, visited us 7 weeks after onset of facial paralysis. He has been treated conventional oriental method(acupuncture, massage, warm application, etc). But the degree of his left facial paralysis didn't improve at all He has been treating with SGB 50 times and TENS for 2 months. Temporal and zygomatic branch of his left facial nerve recovered nearly completely but buccal and mandibular branch did not recover completely. We are willing to insist on the early treatment is the best choice in managing of Ramsay Hunt Syndrome.